Provider Demographics
NPI:1255647533
Name:BACK TO HEALTH WELLNESS CENTER INC
Entity type:Organization
Organization Name:BACK TO HEALTH WELLNESS CENTER INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:620-223-0570
Mailing Address - Street 1:202 STATE ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:FORT SCOTT
Mailing Address - State:KS
Mailing Address - Zip Code:66701-2031
Mailing Address - Country:US
Mailing Address - Phone:620-223-0570
Mailing Address - Fax:620-223-4003
Practice Address - Street 1:202 STATE ST
Practice Address - Street 2:SUITE B
Practice Address - City:FORT SCOTT
Practice Address - State:KS
Practice Address - Zip Code:66701-2031
Practice Address - Country:US
Practice Address - Phone:620-223-0570
Practice Address - Fax:620-223-4003
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-25
Last Update Date:2010-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty